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Posterior scleritis presenting as conjunctivitis in a child.

Jyotiranjan Mallick¹, Susant Pujahari¹, Prafulla Kumar Maharana²

¹All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, Odisha, India.

BMJ Case Reports

|December 13, 2016

Summary

A 14-year-old boy with viral conjunctivitis was diagnosed with bilateral posterior scleritis. Prompt treatment with steroids and NSAIDs rapidly improved vision and resolved ocular findings.

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Area of Science:

Ophthalmology
Rheumatology

Background:

Posterior scleritis is an uncommon inflammatory condition affecting the posterior part of the eye.
It can present with varied symptoms, often mimicking other ocular pathologies, leading to diagnostic challenges.

Observation:

A 14-year-old male presented with unilateral eye redness and decreased vision, initially diagnosed as viral conjunctivitis.
Clinical examination revealed conjunctival congestion, disc hyperemia, and retinal striae.
Ocular imaging demonstrated peripapillary serous macular detachment and characteristic 'T' sign with scleral thickening.

Findings:

Bilateral posterior scleritis was diagnosed based on clinical and imaging findings.
The patient showed significant improvement in visual acuity and resolution of macular detachment and retinal striae after treatment.

Implications:

This case highlights the importance of considering posterior scleritis in the differential diagnosis of acute visual disturbances, even in young patients.
Early diagnosis and appropriate treatment, including topical steroids and oral NSAIDs, are crucial for favorable visual outcomes in posterior scleritis.